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HomeMy WebLinkAboutSpecialty Permit ApplicationIf Permit # St. Lucie County Building & .:fining 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 Tel. 561-462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for special 1. 2. 3 Location/Site Address: Parcel ID Number: D�• 031� Office Use Only Section Townshie I Range I NI a e I ZIgnini—iT—Lanause IrLitials U Description of Project or Work Activity: ia✓s���� B % � n� � /�/Gfi G����1/ via91 �.�inl ��ti� . ��ii/L'�� q��.oy,•y�', /,o�� �i�/v (_�� y� t���� s� � . 4. Owners Information Name: Af,3.P�T Address: City: �eP��p�°y late: ./Cz Zip: Phone: a� 6. Value of Construction: $ S. Contractors Information FL Reg/Cert #: County Certfh ;3 0'9 ZS Business Name: 37;v,0-5�1 Xe: Vze C© Phone Fax �� OWNER'S AFFIDAVIT: I certifj, that all of the information contained in this application is correct and that all work will be done in compliance with all applicable laws regulating construction and z ni g. PRINT QUALIFIERS/OWNERS NAME SIGNATURE OF QUALIFIER/OWNER STATE OF FLORIDA, CO�UNT,Y` OF _ ' ACKNOWLEDGED BEFORE ME THIS a� DAY OF WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATION. 7 NOTARY PUBLIC -STATE OF FLORIDA SIGNATURE OF NOTARY TYPE 7PPRINT (seal) TITLE: NOTARY PL BLIC "�E.Mjres: is�ln DD538831 COMMISSIB1` MAY 21, 2010 Bonded T� lG`, Inc. St. Lucie County Specialty Permit Application rev. 7/18/05 dmg NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR. 1MPROVEME`` TO YOUR PROPERTY. IF YOU INTEND TO ' � 'AIN FINANCING, CONSULT WITH Y6UR. LENDER OR r4. ATTORNEY BEFORE RECORDING YOUR NC, OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $5.000. INSTRUCTIONS Please complete all information in. the- space provided.. All information must be printed (use black or blue ink only) or typed. This permit application is to be used only for those activities that are not otherwise included under a primary building permit. This application may not be used for any activity that includes structural alteration. The information to be provided with this application includes: I. Location/Site Address 2. Parcel ID Number 3. Description of Project or Work Activity 4. Owner Information 5. Contractor Information 6. Value of Construction. Indicate the street address or general location of the property where the building activity is taking place. Indicate the tax identification number of the property where the building activity is taking place. Fully describe the activity to take place. Indicate,the:nani.e and address -of the owner of the property on which activity is taking place. Indicate the State of Florida registration number (if applicable), St. Lucie County contractor license number and the name of the business doing the work. Indicate the total value of the work .to take place. Total cost of construction includes all current.retail material and labor costs associated with the building/construction activity: Construction value is used to determine the permit fee. St. Lucie County reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction. ❑ Gas Attach 2 piping schematics with tank size, location, and BTU of each. appliance ❑ .Shed: . Attach 2. plot plans, 2 copies of DCA letter. and plans, 2 anchor specifications. FeIICe Attach 2 plot plans showing location of fence height of fence and type of fence ❑ Siding Attach 2 copies of manufactures specifications ❑ IIVAC Attach 2 residential energy studies, 2 manual J calculations. 2 sets of duct layouts for new system or full replacement This application can be submitted to St. Lucie County Building and Zoning, 2300 Virginia Avenue, Fort Pierce, FL 34982. All permit applications must be filled out completely before submission. No applications Fill be accepted for processing after 4:30 P.M. For assistance in completing this application, please call (772) 462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday. Upon issuance of this pen -nit, required inspections can be scheduled by calling (772) 462-1261. c, i r.,, t,. rn r;n1ty Permit Annlication rev. 7118/05 dmg